Why People Delay a Solution

Sergei Kochkin, Ph.D., Better Hearing Institute, Washington, DC

More than 22 million people in the United States have never tried hearing aids as a solution to their hearing loss. In one research investigation, close to 3,000 individuals with self-reported hearing loss were polled regarding their reluctance to try hearing aids. Here are some of the reasons why they have declined to pursue them.

1. Inadequate information

Many people are not aware they have a significant hearing loss, and therefore, are in need of information that would help them recognize it. Most people lose hearing gradually. In most cases, the person with hearing loss and family members learn to adapt to it, often not even realizing that they are doing this. The number one reason why people buy their very first hearing aid is the "recognition that their hearing got worse." Usually this means they made embarrassing mistakes in society due to their untreated hearing loss. Thus, one of the first things individuals with suspected hearing loss should do is determine if they exhibit some of the signs of hearing loss.

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2. Stigma and Cosmetics

Some people reject hearing aids because they are concerned with the stigma of hearing loss or are in a state of denial, and thus try to hide it from others. It's unfortunate, but many people lose confidence in themselves simply because they have hearing loss. They believe others will think they're getting older less competent, less attractive, and so on. They may also be embarrassed due to the fact that we live in a youth-oriented, airbrushed society where physical perfection is stressed as an important human attribute.

Cosmetics no longer need to be a barrier to obtaining amplification. Since the 1990s, technological advances have permitted the hearing aid industry to develop hearing aids like completely-in-the-canal (CIC) devices, which are essentially invisible. In fact, research shows that 90% of consumers perceive these CICs to be completely invisible. Based on your hearing needs and the physical characteristics of your ears, you might be a candidate for these devices. If you are not, in-the-canal (ITC) devices, which are only slightly larger are available to fit many hearing losses.

It is likely that once you begin hearing through amplification your quality of life will be enhanced and cosmetics will be of less concern to you. Research shows that people who have come to enjoy their hearing aids rate even the largest hearing aids as cosmetically appealing as smaller, in-the-ear models. Some hearing aids even come in bright colors-dispelling the myth that they are something to be ashamed of or hide!

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3. Misdirected Medical Guidance

Many people have received misinformation about hearing aids from well-intending physicians. For instance, many physicians have told their patients that they're not candidates for hearing aids if they have hearing loss in one ear and good hearing in the other (unilateral hearing loss); if they have "nerve deafness" (an obsolete term for sensorineural hearing loss); or if the hearing loss still allows them to conduct a conversation in quiet. Many times the doctor's opinion will be based on the fact that the patient and doctor are able to conduct a face-to-face conversation in a quiet exam room. Much of this misinformation is given unintentionally by family physicians who do not specialize in hearing problems. In fact, most physicians receive very little training in medical school in the areas of hearing loss and hearing aids.

4. Not Realizing the Importance of Hearing

Another reason for rejection of hearing aids is that people have forgotten how important hearing is to their quality of life. We live in such a visually oriented society that often, hearing plays a secondary role. As you probably know from your own experience, people who cannot hear well often experience anxiety, insecurity, isolation and depression. People gradually withdraw from family and friends because without auditory contact, they lose the feeling of being connected. In essence, they grow numb to the world around them. But in life, communication is critical. We interact with one another through communication.

There are many examples of the importance of hearing well in everyday life.. One good example is a CEO I know who lost more than a million dollars in business because he misheard a client's needs. Learning from this mistake he always wears his hearing aids when meeting with clients especially when negotiating a contract. Another example is a grandfather who was thought to be senile instead of hearing impaired. He was able to compensate for his hearing loss with hearing aids and began to effectively interact with his family again. Most hearing healthcare professionals know of children being misdiagnosed as slow, retarded, hyperactive, or having poor attention spans when in fact these impressions were a consequence of impaired hearing.

5. Misbelief that Hearing Aids Don't Work

A significant number of people with hearing loss mistakenly believe that hearing aids are not effective for what they are designed to do. Recent research, however, indicates that 76% of hearing aid users report satisfaction (defined as satisfied or very satisfied) with the ability of modern hearing aid to improve their hearing, while 66% report that hearing aids have significantly improved the quality of their life. A significant number of people report satisfaction with their hearing aids in quiet situations (87%) as well as in very difficult situations such as restaurants, places of worship or large groups.

Research with more than 25,000 consumers demonstrates that not everyone benefits equally in all listening situations, nor do all types of hearing instrument circuitry perform the same in difficult listening situations. As an example, the average hearing aid achieves a 30% satisfaction rating in noisy situations; yet some technologies, such as instruments with multiple microphones (known as directional hearing aids), achieve satisfaction ratings as high as 81%. Similarly, only about 41% of consumers are satisfied with hearing aids on the telephone, yet, some instruments, such as completely-in-the-canal (CIC) hearing aids perform better on the phone as well as outdoors because they're located just inside the entrance of the ear canal and produce less feedback while on the phone. Much of this satisfaction may also be due to diminished wind noises outdoors, a sense of more natural amplification, and the need for somewhat less power resulting in increased tolerance while in the presence of background noise.

6. Failure to Trust in a Hearing aid Dispensing Professional

Another key reason some people hold off their purchase is: "I do not trust hearing healthcare providers who fit hearing aids!" The data shows that nearly 90% of consumers are satisfied with their hearing aid dispensing professional. It is certainly worth mentioning that the training, education and experience among dispensers of hearing aids has greatly increased over the years for both audiologists and hearing aid specialists.

7. Unrecognized Value of Hearing Aids

Many people who have avoided amplification tend to believe there is little value in hearing aids. By low value they mistakenly assume that "hearing aids will not work for them," and therefore, they will not derive any benefit. Both consumers and physicians have little knowledge of the potential benefit of hearing aids. In recent years, large-scale research has been published on the impact of hearing aids on quality of life for people who use hearing aids in the United States. While we have devoted a full section on the BHI website to this research, it is important to summarize this impact here.

Hearing aids have an impressive list of potential benefits, including greater earning power, improved interpersonal relationships, reduced discrimination toward the person with the hearing loss, reduced difficulty in communicating, reduced anger, frustration, depression and anxiety, enhanced emotional stability, reduced social phobias, greater belief that you are in control of your life, increased self-esteem, improved perceptions of mental acuity, improved health status, greater level of outgoingness (e.g. extroversion) and the list goes on and on. When these findings were recently presented to a group of medical doctors, one prominent physician stated, "I was not aware of the seriousness of hearing loss and the potential for hearing aids to alleviate the problem. Every doctor in the world must be made aware of these findings!"

8. Feeling Priced Out of the Market

Some people with hearing loss simply do not have the disposable income to afford today's modern hearing aids. Based on the known benefits of hearing instruments in improving quality of life there is some effort to see if more government programs such as Medicare will cover hearing aids. If the person with a hearing loss is a child, many local and state governments offer hearing aids at no or reduced cost. Check to see if you qualify for free or discounted hearing aids through your union, employer, the Veterans Administration, insurance provider, local HMO or local charity (i.e. Lions Club) . The BHI website has a comprehensive list of possible resourcesfor financial assistance.

Common Myths

Your hearing loss cannot be helped. In the past, many people with hearing loss in one ear, with a high frequency hearing loss, or with nerve damage have all been told they cannot be helped, often by their family practice physician. This might have been true many years ago, but with modern advances in technology, nearly 95% of people with a sensorineural hearing loss can be helped with hearing aids.

My hearing loss is normal for my age.Isn't this a strange way to look at things? But, do you realize that well-meaning doctors tell this to their patients every day? It happens to be "normal" for overweight people to have high blood pressure. That doesn't mean they should not receive treatment for the problem.

Hearing aids will make me look "older" and "handicapped." Looking older is clearly more affected by almost all other factors besides hearing aids. It is not the hearing aids that make one look older, it is what one may believe they imply. If hearing aids help you function like a normal hearing person, for all intents and purposes, the stigma is removed. Hearing aid manufacturers are well aware that cosmetics is an issue to many people, and that's why today we have hearing aids that fit totally in the ear canal. This CIC style of hearing aid has enough power and special features to satisfy most individuals with hearing impairment. But more importantly, keep in mind that "a hearing loss is more obvious than a hearing aid." Smiling and nodding your head when you don't understand what's being said, makes your condition more apparent than the largest hearing aid.